Utilization Management – Authorizations
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Simplify Utilization Management in Mental Health With PIMSY’S Authorization Functionality
Many services require authorization before they can be performed (sometimes referred to as “pre-auths“). Manually handling this process can lead to workflow challenges, inefficiencies, and denials. Whether your authorization needs are handled via managed care with bundled services or the more traditional “date and unit limits” authorization, automating the process with PIMSY will save you time and improve workflows.
PIMSY automates and streamlines the authorization process, reducing errors and improving compliance. It automatically deducts units based on your predefined decrements when services are performed. Additionally, PIMSY prohibits services outside of that authorization’s limitations (date range, billing code, units, etc.). The result is a structured and efficient system that decreases denials and administrative burdens.
Key Advantages of PIMSY’s Authorizations Functionality
- Centralized authorization management tracks each client’s status from one platform.
- Receive real-time updates to make better, faster decisions about client treatment planning and delivery, ensuring care is never delayed by missing authorizations.
- Automated alerts and reminders notify users when authorizations are nearing expiration or units are running low, preventing gaps in treatment and ensuring timely renewals.
- Audit trail tracks authorization-related activities.
- Reporting and analytics identify trends, highlight areas for improvement, and optimize workflows.
- Bulk Management enables users to add or update billing codes for patients, payers, clinicians, and other entities.
- With PIMSY’s unique Authorizations Group functionality, the system can decrement units from a group of billing codes, rather than from individual codes, a feature tailored to flexible and bundled billing scenarios that are rarely addressed by standard EHRs.
- The Global Authorization Screen displays all authorizations, which can be easily filtered or exported, and features an at-a-glance view of expiring or low-unit authorizations.
PIMSY utilization management boosts efficiency, reduces denials, and improves mental health care delivery. This structured approach enables professionals to focus on patient care, rather than paperwork.
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